Care Home Finance/Care needs assessment LA

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Hi,

Tomorrow we are looking at our first care home (assuming the time we have just given them is ok). I have spoken to the LA and they say to get in touch with them when mum has around 2 months worth of self-funding left. In numbers it looks like:

Mum's savings 35k approx
Upper limit 23k approx
Balance 12k
The home will assess mum but on her current needs they have given a approx figure of 850 per week

This means that on day one of her arrival in the home we are already around 2 months from mum hitting the upper limit.

I will then have to arrange a care needs assessement which I understand looks at the home to make sure it meets mums requirements (Alzheimers) and is not a 5 star hotel.

The financial assessment then takes place. What does this look like?

thank you

So it sounds as if you’ve already met the LA’s criteria for contacting them. Better now than risk having to move her.

presumable she doesn’t have a house to sell?

You can find out from the home whether they take Council funded people

The financial side of things for our late aunt, just confirmed she could self fund and also i had to show land registry docs which proved her house was in a trust for my mum and myself and set up some 30 years before going into care so they couldnt force a sale...aunt died with 27k left in savings having spent some 400k on fees....good luck...a social worker might be useful also if you have issues and the elderly charities have info on their websites .

A care needs assessment is different from a finance assessment. You need the CN one done asap or else you could end up with her being assessed as not needing residential care after her self funding runs out.
I made an appointment with someone from the finance team at the LA. Took all of my stepfathers bank statements and house info. Completed the form together. It then too them 2 months to sort it! He wasn’t a self funder though.

Thank you

I thought the CN and FA were linked so I need to get onto the CN.

Mum doesnt have a house to sell as Dad lives there

I spoke again to the LA who said that as soon as we agree a place then to call them and they will get the FA ball rolling. They said they would need up to 12 weeks and given that mum's self funding is just shy of that they need to be informed immediately.

They suggested that the CN was along the lines of 'is the home satisfactory and not to extravagant for her needs'.

They have separate accounts with Dad have a bit more in his account. Not sure if this will cause any issues as I 'guess' they may want to look at both parents financial situation - not sure on this one?

The also advised to make sure I look at geographical boundaries as some areas that may not seem obvious tip us into the county council and then things get more complex.

I really hope tomorrow works out as it is more or less across the road from Mums doctors and that alone will give her some comfort. I fully expect my parents to try to dig their heels in. We had another bad weekend with another ambulance called (2 in 4 days so it is getting worse). For the first time my mum became aggressive with dad by shaking and pointing his walking stick at him.

Given mums diagnosed alzheimers and her hospital/GP/Paramedic history it 'should' be clear to the LA that she needs residential care. It is her birthday today and due to work I could not see her. I am going tomorrow after the care home but she does not know its her birthday. There was a card and gift at the weekend and she asked if it was her birthday. I explained it was on Tuesday but she has no concept of days therefore seeing her tomorrow is not going to be a loss for her.

thank you

MIL is in a similar financial position, so I'd be interested to see any updates, OP. I presume the LA will put a charge on her half of the house FIL still lives in, but this is pure supposition on my part, and not much else other than MIL's deterioration has gone as expected. Good luck. It's not easy, any of it.

Don't forget that she may have money coming in which means that the savings don't drop quite as fast as you may think depending on what her income is. Still drops fast possibly but not quite as fast. I know a financial assessor in one London authority I worked in many years ago who would put all the savings income and expenditure into a spreadsheet and work out roughly when this would be to set a reminder to re-assess. From subsequent experiences I think it may be unusual for Local authorities and the onus is on the person or whoever is dealing with things on their behalf to keep on top and inform of changes.

As pp said above the care needs assessment and financial assessment are separate. Neither the care needs assessors or the financial assessors are independent financial advisors so please don't rely on them in that way. Some financial assessors can be very helpful with maximising benefit income etc.

You do not need to give your dads financial details unless there are joint accounts or investments. Once they live separately you need to make sure the benefits agencies are informed eg pension credit, DLA, PIP. They will be treated as single for benefits. Self funders retain all their AA, DLA, PIP but this changes once under the threshold and only mobility components of DLA/PIP is kept (and not taken into consideration for the financial assessment).

My understanding is that you can ask your LA to arrange the care for your mum and make the placement but as a self funder they can charge arrangement fees for that on top.

I think Age UK has hotlines that can give advice about all this which may be useful.
Does your mum still have capacity to manage her finances? Do you have a Lasting power of Attorney?

If you find a home over the boundary of your area that you like, ask them to clarify the complexities of her being placed there.

If your parents own their home together then it will not be taken into consideration in any way at all while your dad remains there.

Interesting. I just told the Council that Dad was self funding so a financial assessment wouldn’t be required. The home didn’t require any evidence of means, presumably because they also have LA funded residents so they know they’ll get their money from somewhere.

They have separate accounts with Dad have a bit more in his account. Not sure if this will cause any issues as I 'guess' they may want to look at both parents financial situation - not sure on this one? They should treat the two accounts as separate, but they may want proof that your mother hasn’t been passing money to your father to avoid it being taken into account. They could find that from payments out of your mother’s account. They don’t need to see his.

Does she get Attendance Allowance? I don’t know whether you can get it sorted this quickly (if you phone for a form they’ll back date to the date of your phone call) but while she is completely self funded she can get attendance allowance. It stops once the LA starts to contribute.

I understand some LA are more thorough than others....!...social worker looked quite dismayed when she saw the house held in a water tight trust so was not counted as assets...!

If over a certain age, they cannot do this....info on internet about this.

Don't forget that her state pension will still be coming in, and any other pensions - so her savings should not drain away quite as quickly as you think.

Also your DF will qualify for reduction in council tax as he will be living alone, don't forget to claim that.

Your mother will be assessed on her assests not your dad's. In respect of capital she will have to contribute £1.00 for each £250.00 or part thereof for capital she holds between £23,250 and £14,250.00. They will also take into account all income and deduct the personal allowance of approx £25.00. So her contribution will be tariff income on capital plus income less personal allowance. Her property will be disregarded whilst her husband resided there.

Thank you all.

Dad is living at home and they have Tenants in Common on the house. His physicality is poor to very poor and mum will not let anyone in the house to help him. She is very dominant with him.

We have had LPoA in place for both of them for some years; health and welfare as well as finance and property.

Our application for a 25% reduction in council tax is pending and is based on mums alzheimers. This can swap over to dad if/when mum goes into care.

Mum gets the lower rate AA and this will be removed after 28 days in care. Dad will continue to receive his higher rate AA.

Mum gets a state pension but no pension credits or in fact a full state pension. She has no other income. Dad is the one with the work pensions etc. This means he will be fine if/when mum goes into care.

After further investigation it seems the Care Needs have two main questions

1. Does she need residental care?
2. Is the residential care appropriate (i.e. is it a reasonable cost for the LA to bear)

We have used the Care Home Selection (CHS) service which is free and I would HIGHLY recommend the service to anyone. They take the persons needs (the assessment by phone took around an hour) and then they email all of the relevant care homes, based on needs and any other criteria you give them. In our case it was restriced by geography and that LA funding would be required. Once they match the care homes they email a list. You choose which ones you want to see and CHS manage the appointments for you. The arrange care home assessments for the patient etc. Our Adult Services put us on to them and they have been great. I 'assume' its available throughout the country.

Dad has a bit more in his account than mum but then he has a lot more income than her. My Dh manages all of the finance will full transparency with me and my Dad, although Dad is happy to have the responsibility taken away. Dh has managed the finances for quite a while and had the Financial Assessment in his mind each time he makes an out of the ordinary transaction.

One of the things we have been mindful of is to try to put a long term solution in place. This means that although we could self fund for a short while it could mean the LA would not then continue when the money ran out or indeed the care home would not accept LA funding. From the outset the CHS have only looked for homes that accept LA funding which changes the mix of available homes. We hope that once in place then mum will be settled and that is important to Dad and us.

I am absolutely dreading what is going to happen and I have no idea at present how I am going to cope. I flip flop from she will be fine at home to she absolutely needs residential care. My dads life is an utter misery and he is exhausted as well as being in fear of her. I know in my heart what the answer is but that does not make it any easier

thank you

AA should only stop after 28 days if she is receiving Local Authority funding for her care. As long as she is paying the full cost then AA remains in payment.

Check your mums entitlement to benefits as a single person. You can do this on the .gov website and ones like entitled to. It sounds like a pension credit claim could be made when in the care home as she doesn't have a full state pension and no other income. Whilst living with your dad his income counts and she may not be entitled to means tested benefits like PC but when she moves into a care home she will be entitled. You will need to let the DWP know that's she's in care and that she's self funding to start with. They will write to the LA to confirm this (or at least they used to). This is also something that the financial assessment team should pick up on as it's in their interest to maximise your mothers income. You will need to inform AA when she stops self funding.

It's a lot to deal with but you sound very on top of it and a big help to your parents.

@euff thank you so much for the additional information. Yes I did not pick up that the first 14 weeks she will self fund and can keep her AA. Didn't think to inform the DWP so will do that as well. I will raise with the LA during the FA when that happens.

Visit at 11am today and massively conflicted as I guess everyone is in this situation. I am the only one with Health and Welfare my DH has Finance and Property as do I. My brother and sister have had very little involvement. This makes me the sole decision maker. As others have said I will try to get dad onboard but he has said several times that he does not want her to go into care. Unfortunately he is not of sound mind either given his life over the last few years. If we like the home (me and Dh) then I will just have to work it out from there but would like to do it after Christmas as the guilt of doing it before would be crushing.

I felt quite strongly that if we weren’t seeking a financial contribution, they didn’t get to root around in my father’s personal financial affairs. And I couldn’t face the hassle, not on top of everything else.

as the guilt of doing it before would be crushing. Rationally, there should be no guilt in doing what you think best for your mum. I know that won’t help!

OP hope today has gone okay. Have not yet gone down this path ourselves but know it's hard. Hopefully you find a nice home, where your mum settles and is as happy and comfortable as can be. Don't feel guilty, this is very difficult and the best thing for everyone's health and happiness.
Your mum will have 24hour care and your dad will have less stress.

Self funders do not need to share any financial details. If care arranged through the local authority they will usually ask for a declaration to be signed and not push for details. If they reach the point that they need funding they will need to share and likely provide a little financial history same as benefits agencies do. LA's can and do look up some info for themselves like property ownership etc. If you are close to the threshold when you start care it makes sense to share that.

Even when the LA is part funding the care you can still spend her money on her and others as she may have done when she had capacity. The statutory minimum personal allowance that may be quoted in the assessment which is around £25 (can be higher depending on the income the person receives) is just that - a minimum that the LA have to discount from the assessment so the person has something for personal spending. You can still use capital to decorate her room and make it hers, buy flowers, furnishings, nice clothes, trips out, hair styling and anything else she may like, enjoy or need. You can also do things like arrange a prepaid funeral plan if she/ your family wants.

I work for social services and we would do the financial assessment with about 2 months money left but the care needs assessment may come a lot later, even after the pick up date, as we are so busy at the moment we can't prioritise people who are already placed and therefore safe over those who need urgent help.

I've got so many cases I can't think straight, including pick ups. I always make sure the home knows we are in the process of picking up and the funding will always be backdated if it goes past the date.

I don't know where you but where I work £850 isn't a bad rate and it's likely it would be the best value anyway. Especially if they already have funded residents. Home often come down on price for funded places too.

There is always a risk the home won't be the cheapest option and we would want to move your mum and if she's only been there a while this is more likely than if she'd been there years, but honestly I've been doing this job a long time and only moved two people who were in very £££ placements.

Based on what you say it's unlikely we'd find your mum ineligible for residential.

We just couldn't assess her now like others are suggesting due to our capacity. We are struggling to recruit like most jobs in this sector and we have lots of of long term sick as well as frequent short term sick at this time of year. It's crazy and very very busy.

If care arranged through the local authority they will usually ask for a declaration to be signed and not push for details. I think this must vary. We weren’t asked to sign, although it was documented in a letter that we ldid not wish for a financial assessment “. Not a slip-shod LA either, it’s one with a reputation of looking particularly carefully at property histories and rooting out those who have “given” their house to their DC

Thank you for your replies

@uncomplicatedish I thought the staff were stretched at the LA but I will remember to make sure that even if the CN takes longer then there is some kind of committment from the LA

£850 pw seems more than reasonable given the costs of some other homes. Mum and Dad have lived in the same area all of their lives and as the decades have rolled by the area has become quite deprived therefore the care home costs reflect the area. It is by no means a luxury home and given the stretched services and the reasonable cost I would expect mum's care to be signed off for the particular home. One of the points for the home was that it does have currently funded residents and they are happy to accept new LA funded residents. Mum's mental health (Alzheimers) is very poor although her physical health is very good.

@euff I am not sure that at this late stage that paying for a pre arranged funeral would be looked on in a positive light by the LA. I will however start looking today to see what can be done.

It was a bit of a 'British Comedy' sketch yesterday. I took my parents to the GP for an 11:30 appointment for Dad. Mum won't let him out of her sight. The care home appointment was at 1100am so I said I would drop them off early as there is a coffee shop two doors down from the doctors. The care home is more or less opposite the GPs. So I had to drive away, saying I had the dentist, and would pick them up at midday. My Dh arrived and had we met at the top of the road and went into the back entrance of the care home so they did not spot us.

The home has capacity for 39 residents with one en-suite and 3 non-ensuites avialable. There are 5 staff during the day, 4 in the evening and 3 at nighttime. Not sure if this ratio is good or not?

It had a refurb around 3 years ago and a needs to improve CQC 3 years ago. The most recent CQC which was last year says it has improved and is not rated Good.

The building is old and it looks homely inside with wallpaper in the rooms rather than stark white/cream walls. The rooms are quite small although the en-suite ones are very reasonable.

The lead carer who showed us around was utterly lovely and had worked there for the last 16 months. Her mum had worked there for over 20 years. The place had a good feel and Dad can visit everyday as it is on the bus route outside his house and near to the GP where he goes. They will even give him his dinner so he can sit with mum. They are a specialist Dementia home and overall I would say that I would be happy with mum in that home.

I now have to make a decision as the rooms don't hang around too long especially if they have emergencies. My Dh thinks the time is right now as does my DSis (who has only seen them 3 times this year) and my DB has no input. I can't bring myself to split them up after over 60 years together. It is heartbreaking. My Dh asked if I was waiting for another incident that meant mum had to go into care and I think he is right. Mum is deteriorating more rapidly and dads health with type 2 diabeties is dreadful. They stuggle to take care of themselves and dads life is a misery. I know the right answer but as I said I just cant split them up. I have been together with my Dh for over 40 years and would never want to be split up. I have no idea how you can make a decision like this. You can look at all of the facts and find all of the best options but that does not take emotions into account

Thank you again

Sorrry should say *now rated good

It doesn't sound like the relationship is healthy now though if you're DM is having a negative effect on your DF as you've stated in posts. In those circumstances the best thing for both of them is to separate them, regardless of the fact they've been together for 60 years. It must be an awful situation to be in and very hard for you to ultimately be the decision maker but it sounds like you have found a good viable option which will be better for both your parents. Try and look at it from the positive points rather than the negative of splitting up a couple after 60 years.

The home has capacity for 39 residents with one en-suite and 3 non-ensuites avialable. There are 5 staff during the day, 4 in the evening and 3 at nighttime. Not sure if this ratio is good or not? My father’s home is similar size, I think a similar number of staff, but it’s a nursing home so has 2-3 nursing staff on top of that (I’m going by 3year old memory of what I was told plus how many I see around during the day). Plus activities coordinator, laundry lady, two cooks, manager, office person, handyman.

You’ll probably find the en-suite is more expensive. Our rooms are also priced by size.